Active NPI
Robert Douglas Peckens Jr., RPH
- Pharmacist
- Steubenville, OH
National Provider Identifier
1972051050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03114842
- Practice address
- 264 S Hollywood Blvd
Steubenville, OH 43952-2422 - Phone
- (740) 266-2894
- Fax
- (740) 266-2885
- NPI assigned
- Sep 16, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03114842 | OH | Primary |
| Pharmacist | 183500000X | RP0004805 | WV |
Addresses
Primary practice location
264 S Hollywood Blvd
Steubenville, OH 43952-2422
Mailing address
264 S Hollywood Blvd
Steubenville, OH 43952-2422
Phone (740) 266-2894
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03114842 | OH | MD | Pharmacist |
| RP0004805 | WV | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Kroger Co | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Steubenville, OH
- NPI 1366476061
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473984000000",
"number": "1972051050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "264 S HOLLYWOOD BLVD",
"city": "STEUBENVILLE",
"state": "OH",
"postal_code": "439522422",
"telephone_number": "740-266-2894",
"fax_number": "740-266-2885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "264 S HOLLYWOOD BLVD",
"city": "STEUBENVILLE",
"state": "OH",
"postal_code": "439522422",
"telephone_number": "740-266-2894",
"fax_number": "740-266-2885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PECKENS",
"first_name": "ROBERT",
"middle_name": "DOUGLAS",
"name_suffix": "Jr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-09-16",
"last_updated": "2016-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03114842",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WV",
"license": "RP0004805",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Steubenville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.